Symptoms and signs of port-related infections in oncology patients related to the offending pathogens

Abstract

Summary Aim: There is limited information about symptoms and signs of port‐related infections linking to their offending pathogens. Methods: Oncology patients proven to have port‐related infections were retrospectively analysed. We divided them into two subgroups according to their symptoms and signs. Onset of fever and chills with or without hypotension following the port flush was classified as ‘port flush form infection’. Presence of local inflammatory signs, including erythema, warmth, tenderness and pus formation and systemic infection signs, including fever, chills with or without hypotension was classified as ‘local inflammatory form infection’. Results: There were 29 episodes of port‐related infection among 28 patients, with port flush form 22 episodes and local inflammatory form seven episodes. Of 22 episodes of port flush form infections, 20 (91%) were nosocomial glucose non‐fermenting gram‐negative bacilli, with Acinetobacter baumannii (11 episodes, 50%) and Enterobacter cloacae (four episodes, 18%) the most common. Polymicrobial infections occurred in four episodes (18%). Candida infection occurred in two episodes (9%). Of seven episodes of local inflammatory form infections, six (86%) were gram‐positive cocci, with Staphylococcus aureus (five episodes, 71%) the most common. The time from port implantation to its infection was 272 ± 255 days (30–993 days) for the port flush form infections and 82 ± 87 days (22–265 days) for the local inflammatory form infections. This difference was not significant difference (p = 0.068). Conclusions: The differences between infection of patients with port flush form and local inflammatory form in incidence and offending microorganism suggest that the aetiology of infection were different.

Defining Bloodstream Infections Related to Central Venous Catheters in Patients With Cancer: A Systematic Review

“…The next most frequently used definitions included aspects of the CDC definition; one definition included a positive catheter tip culture result (ie, requiring catheter removal; n 5 19) [61][62][63][64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79], and the other by the Infectious Diseases Society of America (IDSA) included a positive catheter tip culture result or a differential growth rate or quantitative results between percutaneously and CVC-obtained blood cultures (n 5 18) [41,44,48,55,[80][81][82][83][84][85][86][87][88][89][90][91][92][93].…”

Incidence and risk factors for central venous access port-related infection in Chinese cancer patients

“…Other studies were in agreement with the current result that Gram-negative bacteria has become the most common pathogen for CPI in recent decades. 6,12 Staphylococcus supp. was the second most common pathogen.…”

Port type is a possible risk factor for implantable venous access port-related bloodstream infections and no sign of local infection predicts the growth of gram-negative bacilli

“…Furthermore, gram-negative bacilli, and especially glucose non-fermenting pathogens, tend to be the most common microorganisms accounting for port-related infections [ 7 , 28 ]. Interestingly, Liaw et al [ 13 ] reported that in patients with local inflammation, Staphylococcus species were the most common; however, in patients without local port inflammation, up to 91 % of the cases involved nosocomial glucose non-fermenting gram-negative bacilli, with Acinetobacter baumannii and Enterobacter cloacae being the most common. We further found that the patients with no signs of local venous port infection had a significantly higher rate of gram-negative bacilli.…”

“…An IVAP-related BSI was defined according to the definition reported by Liaw et al [ 13 ] as (1) clinical features of infection, fever, and chills but no identifiable focus of infection elsewhere and (2) isolation of the same organism from the catheter tip and peripheral blood cultures. A probable IVAP-related BSI was considered on the basis of fever and chills following port flush and a positive blood culture result but no identifiable focus of infection elsewhere.…”